<div class=grid_18>
<div class=grid_10> 
    <div class=block-border> 
        <div class=block-header> 
            <h1>SDA Church - Kwabrafoso: Enter Disciplinary Action</h1><span></span> 
        </div> 

        <form id=validate-form class="block-content form" action="add" method=post>
                         
            <div class=_50> 
                <p><label for=datepicker>Decision Date</label>
                    <input id="disdate" name="disdate" class="required" type="date" value=""/></p> 
            </div> 

            <div class=_50> 
                <p><label for=textarea>Membership ID No</label> 
                    <input id="mshipno" name="mshipno" class="required" class="input-xlarge" type="text" value=""/></p> 
            </div>  
                
            <div class=_50> 
                <p><label for=textarea>Name</label>
                    <input type="text" id="name" name="name" class="required" value=""/></p> 
            </div> 

            <div class=_50> 
                <p><label for=textarea>Statement of Offence</label>
                    <input id="offence" name="offence" class="" type="text" value=""/></p> 
            </div> 

            <div class=_50> 
                <p><label for=textarea>Business Meeting No</label>
                    <input id="buzmid" name="buzmid" class="" type="double" value=""/></p> 
            </div> 
            
            <div class=_50> 
                <p><label for=textarea>Church Decision</label>
                    <input id="conclude" name="conclude" class="" type="double" value=""/></p> 
            </div> 
                
            <div class=_50> 
                <p><label for=datepicker>Start Date</label>
                    <input id="sdate" name="sdate" class="" type="date" value=""/></p> 
            </div> 

            <div class=_50> 
                <p><label for=datepicker>End Date</label>
                    <input id="edate" name="edate" class=" " type="date" value=""/></p> 
            </div>

            <div class=_50> 
                <p><label for=textarea>Duration </label>
                    <input id="duration" name="duration" class=" " type=" " value=""/></p> 
            </div> 
            
            <div class=block-actions> 
                <ul class=actions-left> 
                    <li><a class="button red" id=reset-validate-form href="javascript:void(0);">Reset</a></li> 
                </ul> 
                <ul class=actions-right> 
                    <li><input type=submit id="Save-Expenditure" class="button" value="Save Record"></li> 
                </ul> 
            </div> 
        </form> 
    </div> 
</div> 